An adolescent client reports to the nurse of walking with a limp due to pain localized in the right knee which worsens at night but denies any recent injury or trauma. The nurse observes swelling and tenderness in the right lower thigh, and imaging results reveal radial ossification in the soft tissues.
Which condition should the nurse consider as the probable cause of the findings?
Osteosarcoma
Growing pains
Rhabdomyolysis
Hemosiderosis
The Correct Answer is A
The adolescent client's symptoms of localized pain, swelling, and tenderness, particularly at night, are suggestive of a malignancy such as osteosarcoma, which is the most common primary bone tumor in children and adolescents.
Radial ossification in the soft tissues is a characteristic finding in osteosarcoma and is indicative of bone production by malignant cells. Other imaging modalities, such as X-rays, computed tomography (CT), and magnetic resonance imaging (MRI), may also reveal osteolytic or osteoblastic lesions in the bone.
Growing pains are a common, benign condition that occur in children and do not typically present with the
symptoms described in the case scenario.
Rhabdomyolysis is a medical emergency that involves the breakdown of skeletal muscle tissue and release of muscle fiber contents into the bloodstream. It can present with muscle pain, swelling, and tenderness, but typically occurs as a result of injury, infection, or drug toxicity.
Hemosiderosis is a rare condition characterized by the accumulation of iron in various tissues, including the liver, spleen, and bone marrow. It may present with symptoms such as fatigue, joint pain, and abdominal pain, but is not typically associated with the symptoms and imaging findings described in the case scenario.
Therefore, the nurse should consider osteosarcoma as the probable cause of the adolescent client's symptoms and imaging findings, and should collaborate with the healthcare team to develop a plan of care for diagnosis and treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The most significant finding in planning care for this family is that the infant's diaper area shows severe skin breakdown. Severe skin breakdown in the diaper area can be a sign of diaper rash or other skin irritation, which can cause discomfort and disrupt the infant's sleep. Addressing this issue can help improve the infant's comfort and promote beter sleep. The other options (A, B, and C) may also be relevant, but severe skin breakdown in the diaper area is the most significant finding in this situation.
Correct Answer is A
Explanation
Children with autism spectrum disorder may have difficulty with sensory processing, social interactions, and communication, which can contribute to feeding difficulties and failure to thrive. Providing structured meal times is an important intervention to help establish a routine and promote consistency and predictability.
Structured meal times involve setting a specific time for meals and snacks, providing a calm and quiet environment, and limiting distractions. This can help the child focus on the task of eating and reduce sensory overload that may interfere with feeding. The nurse should also ensure that the child is seated comfortably and at an appropriate height for feeding.
Offering food even if disinterested (B), incorporating play during meals (C), and allowing multiple food choices (D) are not necessarily helpful interventions for a toddler with autism spectrum disorder and failure to thrive. Offering food when the child is not interested may reinforce negative feeding behaviors and can contribute to further feeding difficulties. Incorporating play during meals may distract the child from the task of eating and can be counterproductive. Allowing multiple food choices can be overwhelming for the child and may not promote a consistent and structured feeding routine.
Therefore, the nurse should prioritize providing structured meal times as an important intervention for promoting feeding and growth in a toddler with autism spectrum disorder and failure to thrive.
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